Fentanyl-associated illness among substance users — Fulton County, Georgia, 2015

• Published in: The American journal of emergency medicine Vol. 36; no. 11; pp. 2115 - 2117
• Main Authors: Angela Parham, M., Pomerleau, A.C., Peralta, G., Drenzek, C.L., Edison, L.S.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2018; Elsevier Limited
• Subjects: Adolescent; Adult; Aged; Amphetamine-Related Disorders - epidemiology; Amphetamine-Related Disorders - urine; Amphetamines; Analgesics, Opioid - adverse effects; Analgesics, Opioid - analysis; Case-Control Studies; Cocaine; Cocaine-Related Disorders - epidemiology; Cocaine-Related Disorders - urine; Comorbidity; Drug abuse; Drug overdose; Drug Overdose - epidemiology; Drug Overdose - etiology; Drug Overdose - mortality; Emergency medical care; Emergency medical services; Emergency Service, Hospital; Female; Fentanyl; Fentanyl - adverse effects; Fentanyl - analysis; Georgia - epidemiology; Hospitals; Humans; Male; Medical records; Middle Aged; Narcotics; Opioid abuse; Opioid-Related Disorders - complications; Opioid-Related Disorders - epidemiology; Opioid-Related Disorders - urine; Overdose; Patients; Public health; Substance Abuse Detection; Substance use; Suicidal behavior; Trends; Urine; Young Adult; Georgia; Atlanta Georgia; United States > US; Fentanyl; Drug abuse; Opioid abuse
• ISSN: 0735-6757; 1532-8171; 1532-8171
• DOI: 10.1016/j.ajem.2018.03.041

[...]the medical records lacked sufficient data for us to examine the history of substance abuse. If a fentanyl-positive patient is identified, the ED provider can offer additional risk communication regarding the increased danger of the substances the patient is using and potentially provide a prescription for naloxone. [...]tracking prevalence of fentanyl-positive UDS in an ED population over time may be valuable for public health protection, to identify possible outbreaks, or as a sentinel of emerging trends among substance users. Case-Patients (n=79) Control Subjects (n=91) No. % No. % Odds Ratio 95% CI Age range (median) 18–62 (35) 17–67 (41) Age group (yrs) <30 27 34 14 15 3.6 1.4–8.9 30–39 21 27 25 27 1.6 0.7–3.7 40–49 14 18 26 29 (ref) (ref) ≥50 17 22 26 29 1.2 0.5–3.0 Male 59 75 62 68 1.3 0.7–2.6 Race (N=148)a Black 39 49 72 79 (ref) (ref) White 22 28 15 16 2.7 1.3–5.8 Presenting chief complaint Drug overdose 21 27 11 12 4.5 1.6–12.0 Altered mental status 13 16 8 9 3.8 1.2–11.5 Psychological concern/suicidal 12 15 28 31 (ref) (ref) Addiction problem 4 5 3 3 3.1 0.6–16.1 Other 29 37 41 45 1.7 0.7–3.8 Transport, treatment, dispositionb Received naloxone 26 33 8 9 5.1 2.1–12.1 Arrived by EMS 55 70 56 62 1.5 0.8–2.8 Admitted (e.g., medical, ICU, or psychiatric) 23 29 31 34 0.8 0.4–1.6 Table 1 Characteristics of case-patients and control subjects presenting to Hospital A emergency department in Atlanta, Georgia during May 5–July31, 2015 (N=170).